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ECG Quiz

Case History: 

A 46-year old female presents with history of palpitations. 
At the time of palpitations, she also had rapid neck pulsations. 
She presented to emergency and an ECG was done. 
What are the findings? 

What is the diagnosis?

 

AVNRT



The ECG shows a regular narrow complex tachycardia (ventricular rate of approximately 250/min). The P waves are not clearly visible, but there is a small deflection at the end of QRS in various leads. In lead I, this is pseudo r' and in leads this is pseudo s wave. The patient was found to have AVNRT on EPS and slow pathway was ablated successfully.  

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ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

High heart rate

The patient contacts the doctor over phone with this report.   Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine.  Should he be worried about this and come to emergency department as soon as possible? Correct answer-  ECG machine has calculated his heart rate incorrectly.  Heart rate is around 100 beats per minute.  Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods.    Now, should he come to emergency department? Not because of detection of high heart rate.  But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist. 

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